How To Fight Heath Care Fearmongers and Demagogues

My friend, Keith, from New Orleans, just emailed to say he attended a local “town meeting” on health care and tried to get a word in favor but was almost hounded out of the room.

Why are these meetings brimming with so much anger? Because Republican Astroturfers have joined the same old right-wing broadcast demagogues that have been spewing hate and fear for years, to create a tempest.

Mainly because there’s still no healthcare plan. All we have are some initial markups from several congressional committees, which differ from one another in significant ways. The White House’s is waiting to see what emerges from the House and Senate before insisting on what it wants, maybe in conference committee.

But that’s the problem: It’s always easier to stir up fear and anger against something that’s amorphous than to stir up enthusiasm for it.

The White House has just announced a web page designed to rebut some of the insane charges that the right is instigating. That won’t be enough. The President has to be more specific about what he’s for and what he’s against. Without these specifics, the right can conjure up every demon in its arsenal while the middle and left can only shrug their shoulders.

The President needs to be very specific about two things in particular: (1) Who will pay? and (2) Why the public option is so important — and why it’s not a Trojan Horse to a government takeover.

(1) Admit that taxes will have to be raised and that cost-savings won’t be sufficient to achieve nearly universal care. But be absolutely clear that taxes will be raised only be raised on the very top. He needs to decide whether he favors a surcharge on the top 2 percent, or a cap on tax-free employee benefits (which would affect only the very top), or some combination, and then announce which he prefers and why.

(2) Say unequivocally that the public option is essential for controlling costs and getting private insurers to offer people better deals, not at all a step toward a government takeover of health care.

— Being the one public plan, it will have large economies of scale that will enable it to negotiate more favorable terms with pharmaceutical companies and other providers. (Here, he must clear up any confusion about any deal made with Big Pharma.) But this won’t lead to a government takeover of health care. The whole point of cost containment is to provide the public with health care on more favorable terms. If the public plan negotiates better terms — thereby demonstrating that drug companies and other providers can meet them — private plans can seek similar deals.

— It will have low administrative costs — Medicare’s administrative costs per enrollee are a small fraction of typical private insurance costs — but that’s no problem, it’s a strength. One goal of health-care reform is to lower administrative costs. Competition with a public option is the only way to push private plans to trim their bureaucracies and become more efficient.

— While it’s true that the public won’t have to show profits, plenty of private plans are already not-for-profit. And if nonprofit plans can offer high-quality health care more cheaply than for-profit plans, why should for-profit plans be coddled? The public plan would merely force profit-making private plans to take whatever steps were necessary to become more competitive. Once again, a plus.

— The public plan won’t be subsidized by government. Subsidies go to families who need them in order to afford health care. They’re free to choose the public plan, but that’s only one option. They could take their subsidy and buy a private plan just as easily. The public plan may not dip into general revenues to cover its costs. It must pay for itself. And any government entity that oversees the health-insurance pool or acts as referee in setting ground rules for all plans will not favor the public plan.

Now’s the time for specifics. It’s impossible to fight fearmongering lies with nothing but positive principles.

Robert Reich is the nation's 22nd Secretary of Labor and a professor at the University of California at Berkeley.

He has served as labor secretary in the Clinton administration, as an assistant to the solicitor general in the Ford administration and as head of the Federal Trade Commission's policy planning staff during the Carter administration.

He has written eleven books, including The Work of Nations, which has been translated into 22 languages; the best-sellers The Future of Success and Locked in the Cabinet, and his most recent book, Supercapitalism. His articles have appeared in the New Yorker, Atlantic Monthly, New York Times, Washington Post, and Wall Street Journal. Mr. Reich is co-founding editor of The American Prospect magazine. His weekly commentaries on public radio’s "Marketplace" are heard by nearly five million people.

In 2003, Mr. Reich was awarded the prestigious Vaclev Havel Foundation Prize, by the former Czech president, for his pioneering work in economic and social thought. In 2005, his play, Public Exposure, broke box office records at its world premiere on Cape Cod.

Mr. Reich has been a member of the faculties of Harvard’s John F. Kennedy School of Government and of Brandeis University. He received his B.A. from Dartmouth College, his M.A. from Oxford University, where he was a Rhodes Scholar, and his J.D. from Yale Law School.

2 Comments on How To Fight Heath Care Fearmongers and Demagogues

specifics: Even President Obama admits the basic issue with Government created Medicare…it’s single payer, universal for those over 65, permits unlimited demand ….and has no cost controls…has resulted in “bankrupting” the government while simultaneously, through cost-shifting, wrecking the private market. The side effect of the limited Medicare reimbursements in many areas has actually reduced the access to care for the elderly (and Medicaid patients). As a result of other government policies, the working career (productivity) by physicians is on the decline, since more the graduates are female. The average career of a woman in medicine now is only 8-10 years, is less likely to be in an underserved locale, and the average work week for a female in medicine is only 3-4 days. This trend has been in place for 15 years. Now the government wants to expand the major problems of Medicare (reimbursements below cost of service- HR3200 Sections 115 & 313), restrict medical school admissions even more (Sec. 749), add another 50 bureaucracies (plus more regulations) to the entire healthcare system? Of course, plans for Federal officals and employee are exempt from the reimbursement limits (HR3200 sec 223). Can anyone doubt that even more government intervention will cause even more damage (perhaps fatal) to the healthcare market?

I find it impossible to believe that republicans could organize a plot that is nationwide in size, with this level of intensity using rented-mobs … and not screw it up … because they screw up everything. That theory just doesn’t pass the smell test. Hordes of angry senior citizens is what I’m seeing. The mistake the democrats made was to put HR 3200 on the web where people could read it … and they did! I was so impressed with the protesters, who were citing pages and sections, that I had to download it to see if they were telling the truth. For the most part they were. Read it and decide for yourself.